Drug policy reform: Decriminalization, harm reduction, treatment

“There are many things worth living for, a few things worth dying for, and nothing worth killing for.”
Tom Robbins

First word
A FOREIGN reader sent me the quote from American novelist Tom Robbins, in reaction to my column last Tuesday (“For a strategic reset of the drug policy and the drug war”, Manila Times, August 29, 2017).

The author of 21 novels, Robbins writes frequently on paradox and contradiction in life. He has said in an interview: “Reality is contradictory. If you had to pick one word to describe the nature of the universe—I think that word would be paradox.”

Robbins’ play on the phrases: “worth living for”, “worth dying for,” and “worth killing for” is typical of his work. He is provocative and catalytic.

The quote, by the way, is what is called an “anaphora” in rhetoric, which denotes the repetition of a word in successive clauses as a stylistic device. Robbins’ anaphora belongs in the distinguished company of Lincoln’s “government of the people, by the people, and for the people.”

The anaphora forces us to reflect sensibly on both the policy and the violence it has unleashed.
Is the drug menace worth killing for?

Is it worth throwing aside our safeguards for civil liberties?

Does the citizen who uses drugs become less of a citizen and human being?

Reaction to strategic reset

Many readers agreed with my contention that we need a new strategy to fight the illegal drugs trade, as a practical measure to stanch the tide of police abuses and the killing of innocents.

Other readers, probably more in number, were angered by my questions and my ideas for fixing the problem. Some rejected my conclusion that prohibition as a policy is a failure; a number are revolted at my suggestion that we should study decriminalization as a possible policy shift.

After reviewing my mail in their totality, I realized that I did not explain enough the proposed policy reform for readers to fully understand it. Therefore, I return to the subject today, with the intent to discuss Portugal’s drug policy at length and where the world is going on drug policy.

Innovative reforms

There is today a gathering trend among countries to adopt innovative reforms in drug policymaking.
There is a consensus that strict prohibition cannot reduce illicit drug demand and drug harm. Fifteen countries have decriminalized the personal possession of all drugs.

Portugal decriminalized all drug use in 2000 and developed strong new policies on prevention, treatment and harm reduction. This approach is working, with drug use, offenders in prison, court cases, HIV infections and overdoses all decreasing.

In the US, cannabis is decriminalized or legal in some form in 27 states and the District of Columbia. Four US states have legalized recreational cannabis. South Australia decriminalized minor cannabis offenses in 1987, with the Australian Capital Territory and Northern Territory following suit in the 1990s.

Portugal’s nuanced approach

At the turn of the century, Portugal implemented massive reform of its drug policy. Today, the country stands as a global leader of evidence-based policy grounded on the principle of harm reduction. The situation seems to be working, with more people in treatment and fewer new cases of HIV. But the key to this policy was not the legalization of drugs, as many mistakenly supposed.

In fact, what Portugal adopted was a nuanced approach to drug policy.

On the one hand, Portugal shunned a policy of legalization, which some European countries have done. Under legalization, the use, possession, manufacture and supply of narcotic substances do not hold any criminal penalty. Banned drugs would become licit like alcohol and tobacco.

On the other hand, Portugal opted for a policy of decriminalizing drugs by removing criminal penalties for low-level offenses. Decriminalizing an offence does not mean it is legal. Speeding is a good example of an offense that is usually dealt with through a civil penalty.

Portugal has not changed the legal status of any drugs. They all remain illegal; but the offense for possession has been changed from a criminal to a civil one.

Portugal decriminalized the use and possession of all drugs in a way that moves the focus from criminal punishment to treatment.

Drugs are not freely available, and they cannot legally be sold in Portugal. If a person is found with a small quantity of a narcotic (defined as 10 days’ worth for personal use), the drug is confiscated and the person is summoned to a panel called the Commission for the Dissuasion of Drug Addiction.

In essence, Portuguese drug policy has shifted the penalty for drug use from a punitive criminal focus to a health, treatment and reintegration focus.

The police and judicial systems are no longer used to punish people using drugs for a crime. They are being used to help people with a health problem get healthy and stay that way.

New Zealand: new drug policy

New Zealand adopted a new policy with its National Drug Policy 2015-2020. Its Misuse of Drugs Act (MoDA), now 40 years old, needed to be comprehensively redesigned to reflect best practice. While MoDA has been amended 18 times in the past eight years, it has failed to keep pace with changes and now exists as a patchwork of poorly considered amendments and outmoded assumptions.

Meanwhile, MoDA retains a strict prohibition approach for all established drugs. The NZ Drug Foundation believes that the country’s approach needs to shift from being predominantly based on criminal justice to one based on a health and social focus. MoDA’s punitive approach, heavily weighted towards supply control, is ineffective and harmful.

Complex policy challenge

Reforming Philippine drug policy requires our policymakers to tackle the same questions that have haunted policymakers in other countries.

Like others, we need to align our national drug policy with best practice and harm reduction principles. This means addressing the health and social problems underlying demand for drugs and minimizing the problems arising from drug use.

A wealth of evidence suggest that what works is this. A first step is not to criminalize people for personal use/possession offenses, and using such ‘infringements’ only to caution and offer treatment.

To complement this, it pays for government to persist in stopping the manufacture and traffic of illegal drugs.
It has also been suggested that the legalization of some drugs maybe considered. But policymakers cringe at the idea of illegal drugs becoming more available and heavily promoted like alcohol.

No country has tried the tough Philippine policy of killing drug suspects as a solution to the drug menace.

Realistically, this tough policy may have reached the end of the line. President Duterte will avoid shoot-to-kill directives to police and calls for extrajudicial killings. The PNP will tread more warily in launching dragnets and raids in the drug war. There will be more prosecutions of EJKs and more investigations of incidents.

There is merit to the suggestion of one researcher that the Philippines needs to build up real intelligence on the drug trafficking networks that President Duterte says exist in the country, and their corruption networks in the government and law enforcement.

A combination of hard and soft policies could be the future of drug policy in the Philippines.

Beating methamphetamines (shabu) is going to be difficult and elusive. Meth addiction is very difficult to treat.
Hard thinking is needed. Returning the primary task to the Philippine Drug Enforcement Agency (PDEA) could be the change that will avail.